Department of Radiotherapy, Institute of Post Graduate Medical Education and Research, Kolkata, India.
Department of Radiation Oncology, All India Institute of Medical Sciences, Patna, 801507, India.
Breast Cancer Res Treat. 2020 Dec;184(3):839-848. doi: 10.1007/s10549-020-05885-y. Epub 2020 Aug 27.
This study was conducted to assess the correlation between lymph node ratio (LNR) and prognosis of non-metastatic invasive breast carcinoma.
This retrospective study examined 455 patients who were diagnosed with non-metastatic, unilateral invasive breast carcinoma and underwent either breast conservative surgery (BCS) or modified radical mastectomy (MRM) with axillary lymph node dissection (ALND) with at least one lymph node identified in the ALND specimen. Receiver operating characteristics (ROC) curve analysis was used to find out predictive cut-off values of the LNR and negative lymph nodes (NLN).
The median follow-up duration was 38 months. The median DFS and OS were 68 months and 72 months, respectively. 25.1% of patients had reported recurrence. The optimal cut-off value of LNR was 0.40. LNR was found to correlate significantly with pathological T (p < 0.001), pathological N (p < 0.001), and NLN (p < 0.001). Univariate analysis of the patients showed that the age group ≤ 35 years, menstrual status, pathological T, nodal status, lymphovascular invasion (LVI), perineural invasion (PNI), tumor grade, estrogen receptor (ER), progesterone receptor (PR), molecular subtypes, LNR, and NLN can affect disease-free survival (DFS) (p < 0.05) and OS (p < 0.05). Multivariate analysis showed that the pathological T (p < 0.001), menstrual status (p = 0.030), and LNR (p < 0.001) were the independent prognostic factors for DFS. Pathological T (p < 0.001) and LNR (p < 0.001) were the independent prognostic factors affecting OS.
LNR is the independent prognostic factor of DFS and OS for non-metastatic breast carcinoma.
本研究旨在评估淋巴结比率（LNR）与非转移性浸润性乳腺癌预后的相关性。
本回顾性研究纳入了 455 例经诊断为非转移性、单侧浸润性乳腺癌并接受保乳手术（BCS）或改良根治性乳房切除术（MRM）加腋窝淋巴结清扫术（ALND）的患者，ALND 标本中至少有一个淋巴结被识别。采用受试者工作特征（ROC）曲线分析找出 LNR 和阴性淋巴结（NLN）的预测截断值。
中位随访时间为 38 个月。中位无病生存期（DFS）和总生存期（OS）分别为 68 个月和 72 个月。25.1%的患者报告复发。LNR 的最佳截断值为 0.40。LNR 与病理 T（p<0.001）、病理 N（p<0.001）和 NLN（p<0.001）显著相关。患者的单因素分析显示，年龄组≤35 岁、月经状态、病理 T、淋巴结状态、脉管瘤浸润（LVI）、神经周围浸润（PNI）、肿瘤分级、雌激素受体（ER）、孕激素受体（PR）、分子亚型、LNR 和 NLN 均可影响无病生存率（DFS）（p<0.05）和总生存率（OS）（p<0.05）。多因素分析显示，病理 T（p<0.001）、月经状态（p=0.030）和 LNR（p<0.001）是 DFS 的独立预后因素。病理 T（p<0.001）和 LNR（p<0.001）是影响 OS 的独立预后因素。
LNR 是非转移性乳腺癌 DFS 和 OS 的独立预后因素。
